ICD-10 Code R63.3
New York State Medicaid recently notified the State Fiscal Agent, PCG, of excessive denials for ICD-10 code R63.3. Code R63.3 is a non-specific and non-billable diagnosis code. This code is not valid for submission effective 10/1/2021 for HIPAA covered transactions.
Suggested billable replacement codes are:
ICD-10 Code Z13.40
PCG has also been notified that some EI Billing Providers are using ICD-10 code Z13.40 for claims with dates of service prior to October 1, 2018. This code was effective on October 1, 2018 and can only be used for claims with dates of service on that date or after.
If you have any questions, please contact the PCG Customer Service Call Center at (866) 315-3747.
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